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MRCP 1 > Gastroenterology > Flashcards

Gastroenterology Flashcards

1
Q

PBC: associations

A

Sjogren’s, RA, systemic sclerosis, thyroid disease

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2
Q

PBC: features

A

Fatigue, pruritis, cholestasis, hyperpigmentation

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3
Q

PBC; Dx

A

AMA, raised IgM

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4
Q

PBC; Mx

A

Ursodeoxycholic acid

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5
Q

Achalasia; features

A

Dysphagia of liquids and solids

Regurgitation

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6
Q

Achalasia; Ix

A 
Oesophageal manometry
Barium swallow (bird's beak)
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7
Q

Peutz-Jeghers Sx; what?

A

AD condition with hamartomatous polyps in GI tract

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8
Q

Peutz-Jeghers; features

A

Hamartomatous polyps in GI tract
Pigmented lesions on lips, mouth, face, palms and soles
Obstruction
GI bleeding

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9
Q

Acute fatty liver of pregnancy: features

A

Abdo pain, n&v, headache, jaundice, hypoglycaemia

Elevated ALT

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10
Q

Intrahepatic cholestasis of pregnancy: features

A

pruritus, raised bilirubin

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11
Q

Intrahepatic cholestasis of pregnancy; Mx

A

Ursodeoxycholic acid

Weekly LFTs

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12
Q

Causes of C. dif infection

A

Clindamycin, cephalosporins and PPIs

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13
Q

C. dif; Mx

A

Po metronidazole

PO vancomycin

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14
Q

Antibody used in C dif

A

Bezlotozumab

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15
Q

Whipple’s disease; features

A 
WHIPPLE
Watery diarrhoea
Hyperpigmentation of skin
I (eye signs)
Pleurisy
Pericarditis
LN
Enteric involvement
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16
Q

Whipple’s disease; Biopsy

A

Macrophage deposition with periodic acid-Schiff granules

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17
Q

Sulphasalazine; SE

A

Rashes, oligospermia, headache, Heinz body anaemia, megoblastic anaemia, fibrosis

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18
Q

Mesalazine; SE

A

GI upset, headache, agranulocytosis, pancreatitis, interstitial nephritis

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19
Q

Gastrin; source

A

G cells in antrum of stomach

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20
Q

Gastrin; stimulus

A

Stomach distension
Vagal nerve
Peptides / amino acids

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21
Q

Gastrin; actions

A

Increases parietal cell acid secretion
Increases pepsinogen and IF secretion
Increases gastric motility

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22
Q

CCK; source

A

I cells in upper small intestine

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23
Q

CCK; stimulus

A

Partially digested proteins and triglycerides

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24
Q

CCK; actions

A

Increases pancreatic secretions

GB contraction and relaxation of sphincter of Oddi

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25
Q

Secretin; source

A

S cells in small intestine

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26
Q

Secretin; stimulus

A

Acidic chyme, fatty acids

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27
Q

Secretin; actions

A

Increases HCO3 secretion

Decreases gastric acid secretion

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28
Q

VIP; source

A

Small intestine and pancrease

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29
Q

VIP; action

A

Stimulates secretion by pancreas and intestine

Inhibits acid secretion

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30
Q

Somatostatin; source

A

D cells in pancreas and stomach

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31
Q

Somatostatin; action

A

Decreases acid and pepsin secretion

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32
Q

Hepatomegaly; cirrhosis

A

Non-tender firm liver

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33
Q

Hepatomegaly; malignancy

A

hard, irregular, liver edge

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34
Q

Hepatomegaly; RHF

A

firm, smooth, tender liver edge +/- pulsatile

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35
Q

Crohn’s; inducing remission

A
  1. steroid + 5-asa
  2. azathioprine / MTX
  3. Infliximab
36
Q

Crohn’s; maintaining remission

A
  1. azathioprine
  2. MTX
  3. 5-asa
37
Q

Carcinoid tumours: what?

A

Liver metastases and release serotonin into systemic circulation

38
Q

Carcinoid tumours; features

A

Flushing, diarrhoea, bronchospasm, hypotension, RS valve disease

39
Q

Carcinoid tumours; Ix;

A

urinary 5-HIAA

40
Q

Carcinoid tumours; Mx

A

Somatostatin analogues - octreotide

41
Q

LFTs; hepatic

42
Q

LFTs; biliary

43
Q

HBV; vaccinated

A

HbSAg; negative
Anti-HbSAg; positive
Anti-HbCAg; negative

44
Q

HBV; natural immunity

A

HbSAg; negative
Anti-HbSAg; positive
Anti-HbCAg; positive

45
Q

HBV; acute infection

A

HbSAg; positive
Anti-HbSAg; negative
Anti-HbCAg; positive (IgM)

46
Q

HBV; chronic infection

A

HbSAg; positive
Anti-HbSAg; negative
Anti-HbCAg; positive (IgM negative)

47
Q

SBP; Dx

A

Paracentesis; neutrophils >250

48
Q

SBP; Mx

A

IV cefotaxime

49
Q

Bariatric surgery; referral criteria

A

No RF; BMI >40

RF; BMI >35

50
Q

Hepatorenal syndrome: type 1

A

Rapid progression

Very very poor prognosis

51
Q

Hepatorenal syndrome: type 2

A

Slowly progressive

52
Q

Hepatorenal syndrome: Mx

A

terlipressin

53
Q

What is Dubin Johnson syndrome?

A

Benign AR disorder resulting in hyperbilirubinaemia

54
Q

Drugs inducing hepatocellular damage (10)

A 
Paracetamol
Anti-epileptics (valproate, phenytoin)
MAOIs
Halthane
Anti-TB
Statins
Alcohol
Amiodarone
Methyldopa
Nitrofurantoin
55
Q

Drugs inducing cholestasis (6)

A 
COCP
Penicillins
Steoids
Phenothiazines
Sulphonylureas
Fibrates
56
Q

Drugs inducing cirrhosis (3)

A

Methotrexate
Methyldopa
Amiodarone

57
Q

Acute pancreatitis: causes

A 
GET SMASHED
Gallstones
Ethanol
Trauma
Steroids
Mumps
Autoimmune
Scorptio 
Hypertriglyceridaemia
ERCP
Drugs
58
Q

Autoimmune hepatitis: type I

A

Anti-nuclear antibodies +/- anti-smooth muscle antibodies

Affects adults and children

59
Q

Autoimmune hepatitis: type II

A

Anti-liver / kidney microsomal type 1 antibodies

Affects children

60
Q

Autoimmune hepatitis: type III

A

Soluble liver-kidney antigen

Affects middle-aged

61
Q

Angiodysplasia: associations

A

Aortic stenosis

62
Q

Autoimmune hepatitis: associations

A

HLA B8 DR3

63
Q

Bile acid malabsorption: investigation

64
Q

Bile acid malabsorption: Mx

A

Cholestyramine

65
Q

C. dif: Management

A

PO vancomycin
PO fidaxomicin
PO vancomycin +/- IV metronidazole

66
Q

Barrett’s oseophagus: histology

A

Columnar epithelium

67
Q

Monitoring Rx in haematochromatosis

A

Ferritin and transferritin

68
Q

Plummer Vinson syndrome: what?

A

Dysphagia, glossitis, IDA

69
Q

Acute pancreatitis: severe (6)

A 
>55
Hypocalcaemia
Hyperglycaemia
Hypoxia
Neutrophilia
Elevated LDH and AST
70
Q

Child Pugh Score

A 
Ascities
Bilirubin
Albumin
PT 
Encephalopathy
71
Q

Coeliac; HLA

A

HLA DQ2 and HLA DQ8

72
Q

Crohn’s histology

A

Inflammation in all layers of mucosa
Increased goblet cells
Granulomas

73
Q

UC histology

A

No inflammation beyond submucosa
Crypt abscess formation
Depletion of goblet cells

74
Q

Crohn’s endoscopy

A

Deep ulcers
Skip lesions
Cobble stone appearance

75
Q

UC endoscopy

A

Psudopolyps

76
Q

HSM: causes

A 
CLD with portal HTN
Infections; glandular fever, malaria, hepatits
Lymphoproliferative disorders
Myeloproliferative disorders
Amyloidosis
77
Q

HRS: pathophysiology

A

Splanchnic vasodilation

78
Q

Maltase

A

Maltose –> glucose + glucose

79
Q

Sucrase

A

Sucrose –> fructose + glucose

80
Q

Lactase

A

Lactose –> glucose and galactose

81
Q

Melanosis coli

A

Associated with laxative abuse

82
Q

UC Inducing

A

Rectal aminosalicylate
PO aminosalicylate
Steroid

83
Q

UC Inducing in severe disease

A

Topical aminosalicylate and PO aminosalicylate

84
Q

UC Inducing in severe colitis

A

IV steroids / ciclosporin

85
Q

Gastric MALT lymphoma; associations

A

H. pylori infection

86
Q

Oesophageal adenocarcinoma: RF

A 
GORD
Barrett's 
Smoking 
Achalasia 
Obesity

MRCP 1 (16 decks)

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